ABSTRACT
BACKGROUND/AIMS: Peginterferon plus ribavirin remains a standard therapy for patients with chronic hepatitis C (CHC) in Korea. We investigated the efficacy and long-term outcome of peginterferon and ribavirin therapy in Korean patients with CHC, particularly in relation to the stage of liver fibrosis. METHODS: The incidence of sustained virological response (SVR), hepatic decompensation, hepatocellular carcinoma, and liver-related death was analyzed in 304 patients with CHC; the patients were followed up for a median of 54 months. RESULTS: Among patients with HCV genotype 1, the SVR rate was 36.7% (18/49) and 67% (69/103) for patients with and without cirrhosis, respectively (p<0.001). For patients with non-1 HCV genotypes, the SVR rates were 86.0% (37/43) in cirrhotic patients and 86.2% (94/109) in noncirrhotic patients. SVR significantly reduced the risk of liver-related death, hepatic decompensation, and hepatocellular carcinoma, which had hazard ratios of 0.27, 0.16, and 0.22, respectively (all p<0.05). However, despite the SVR rate, patients with advanced fibrosis were still at risk of developing liver-related complications. CONCLUSIONS: A relatively high SVR rate was achieved by peginterferon plus ribavirin therapy in Korean patients with CHC, which improved their long-term outcomes. However, all CHC patients with advanced hepatic fibrosis should receive close follow-up observations, even after successful antiviral treatment.
Subject(s)
Humans , Carcinoma, Hepatocellular , Fibrosis , Follow-Up Studies , Genotype , Hepatitis C , Hepatitis C, Chronic , Hepatitis, Chronic , Incidence , Korea , Liver Cirrhosis , RibavirinABSTRACT
Caroli's disease is a rare autosomal-recessive disorder caused by malformation of the ductal plate during embryonic development. Although it is present at birth, Caroli's disease is typically not diagnosed until between the second and fourth decades of life, as it was in the present patient. Here we report a rare case of Caroli's disease limited to one liver segment, which was initially misdiagnosed as an intraductal papillary neoplasm of the bile duct. The asymptomatic patient was treated with liver segmentectomy.
Subject(s)
Adult , Humans , Male , Bile Duct Neoplasms/diagnosis , Bile Ducts, Intrahepatic , Caroli Disease/diagnosis , Diagnostic Errors , Magnetic Resonance Imaging , Tomography, X-Ray ComputedABSTRACT
Paragangliomas are rare tumors that arise from the extra-adrenal chromaffin cells, and malignancy is defined by the presence of metastases to sites that normally lack chromaffin tissue. The main therapeutic targets are tumor reduction and control of excessive catecholamine secretion. Currently, the adjuvant therapy to surgery is radiotherapy treatment using high-dose MIBG; chemotherapy is currently evolving. We report herein a case of malignant paraganglioma with lung and spine metastasis that occurred 16 years after primary tumor excision and was treated with high dose MIBG radiotherapy and chemotherapy.
Subject(s)
3-Iodobenzylguanidine , Chromaffin Cells , Drug Therapy , Lung , Neoplasm Metastasis , Paraganglioma , Radiotherapy , SpineABSTRACT
Hypereosinophilia is often associated with eosinphilic infiltration of tissue, which can lead to severe and irreversible organ damage. One of the most characteristic and critical complications is development of thrombosis in cardiac ventricles, and occasionally in deep veins. We report a rare case of hypereosinophilia, with peripheral vascular thrombosis, caused by Toxocara canis infection.
Subject(s)
Heart Ventricles , Thrombosis , Toxocara canis , Toxocariasis , VeinsABSTRACT
Acute duodenal ischemia and periampullary intramural hematoma are rare complications after endoscopic retrograde cholangiopancreatography (ERCP). A 77-year-old man with splenomegaly complained of abdominal pain caused by common bile duct (CBD) stone. After successful removal of the CBD stone without immediate complications, the patient developed intramural hematoma around the ampulla of Vater along with diffuse duodenal edema. The findings were compatible with acute intestinal ischemia, and further evaluation revealed that he had underlying primary myelofibrosis. Myeloproliferative diseases are known to be significantly associated with an increased risk of thrombohemorrhagic complications. Therefore, particular attention should be given to this group of patients when a high-risk procedure such as ERCP is performed.
Subject(s)
Aged , Humans , Abdominal Pain , Ampulla of Vater , Cholangiopancreatography, Endoscopic Retrograde , Common Bile Duct , Edema , Hematoma , Ischemia , Primary Myelofibrosis , SplenomegalyABSTRACT
No abstract available.
Subject(s)
Bronchopulmonary Sequestration , Cystic Adenomatoid Malformation of Lung, Congenital , LungABSTRACT
The infantile polycystic kidney disease is rare fetal urinary tract anomaly. It is inherited with an autosomal recessive pattern and recurrence rate is 25%. The gene locus is on chromosome 6p. The pathogenesis of infantile polycystic kidney is the primary defect of the collecting ducts. The ultrasonographic finding of infantile polycystic kidney is oligohydramnios, bilaterally symmetrical enlarged kidneys with maintenance of their reinform shape. The differential diagnosis with adult polycystic kidney disease is important. The massive enlargement of the kidneys is rarely seen in adult polycystic kidney disease and the examination of the parents and other members of the family is helpful to confirm the adult polycystic kidney disease. If there is severe renal involvements, stillbirth or neonatal death secondary to pulmonary hypoplasia would be developed. If it were diagnosed before viability, termination of pregnancy is recommended. In a fetus at risk, diagnosed after viability, pregnancy termination is also recommended since this condition is uniformly fatal. We present a case of infantile polycystic kidney.
Subject(s)
Female , Humans , Pregnancy , Diagnosis, Differential , Fetus , Kidney , Oligohydramnios , Parents , Polycystic Kidney Diseases , Polycystic Kidney, Autosomal Dominant , Recurrence , Stillbirth , Urinary TractABSTRACT
OBJECTIVES: To determine if hysterectomy with or without ovarian preservation is asso-ciated with obesity in premenopausal women. METHODS: 581 women for routine check up from Jan. 1985 to Dec. 1995 in the depart-m ent of Gynecology at Korea Veterans Hospital were included. The obesity was evaluated by BMI(body mass index) scores. 80% of hysterectomy were confirmed from the hospital records. The age, weight, height, blood pressure, menstr- ual history, history of DM and hypertension, social history of alcohol and smoking and other cardiovascular risk factors such as cholesterol, HDL-cholesterol, triglycerides were checked. The 248 women with natural postmenopausal status before hysterectomy, taking hormonal replacement therapy after hysterectomy and having performed hysterectomy due to malign- ancy were excluded. RESULTS: All women performed hysterectomy were in premenopausal status in this study. Therefore, the final numbers of subjects included in the analysis was 333. Hysterectomy wit- hout ovarian preservation were performed in 58 cases and hysterectomy with ovarian pres- ervation were in 57 cases. The 218 premenopausal cases which did not performed hystere- ctomy were considered control group. BMI scores were higher in cases without ovarian pres- ervation than with ovarian preservation. And BMI score was associated with the postoper- ative duration in hysterectomy with ovarian preservation. CONCLUSIONS: We suggest that hysterectomy without ovarian preservation in premeno- paussal women were associated with increased obesity, especially BMI scores.